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A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following?
- A. A client who has a referral for social services
- B. A client who is transdermal to radiology
- C. A client who is transferal to a stepdown unit
- D. A client who has a consultation for physical therapy
Correct Answer: C
Rationale: The correct answer is C: A client who is transferal to a stepdown unit. Medication reconciliation is crucial during transitions of care to ensure accuracy and safety. When a client is transferred to a stepdown unit, their care level changes, necessitating a review of medications to prevent errors. Choice A is not directly related to medication reconciliation. Choice B involves a procedure, not a care transition requiring medication review. Choice D pertains to therapy but does not involve a care transition.
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A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report?
- A. ePTT 90 seconds
- B. Hgb 16 g/dL
- C. INR 1.6
- D. WBC 6,000/mm3
Correct Answer: A
Rationale: The correct answer is A: ePTT 90 seconds. This value indicates a higher than normal clotting time, which could potentially lead to bleeding complications due to excessive anticoagulation from heparin. The other values (B, C, D) are within normal ranges and do not indicate an immediate risk or adverse outcome related to heparin administration. An incident report is necessary to document and address the elevated ePTT to ensure appropriate interventions are taken to prevent harm to the patient.
A nurse is preparing to administer Igrasm 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: 325 mcg
Rationale: The correct answer is 325 mcg. First, convert the client's weight from lb to kg: 143 lb ÷ 2.2 = 65 kg. Next, calculate the daily dose: 5 mcg/kg/day x 65 kg = 325 mcg/day. Therefore, the nurse should administer 325 mcg per day.
Other choices are incorrect because they do not follow the correct conversion of weight to kg and do not calculate the dose accurately based on the weight and prescribed dosage.
A nurse accidentally administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take?
- A. Monitor the client's thyroid function levels.
- B. Collect the client's uric acid level.
- C. Obtain the client's HDL level.
- D. Check the client's glucose level.
Correct Answer: D
Rationale: The correct answer is D: Check the client's glucose level. Metformin is a medication used to treat diabetes, so administering it instead of metoprolol could lead to hypoglycemia. Checking the client's glucose level will help determine if the client is experiencing low blood sugar levels due to the medication error. Monitoring thyroid function (A), collecting uric acid levels (B), and obtaining HDL levels (C) are not relevant in this situation and would not address the immediate concern of potential hypoglycemia.
A nurse is assessing a client who is taking haloperidol and is experiencing pseudoparkinsonism. Which of the following findings should the nurse document as a manifestation of pseudoparkinsonism?
- A. Serpentine limb movement
- B. Shuffling gait
- C. Nonreactive pupils
- D. Smacking lips
Correct Answer: B
Rationale: The correct answer is B: Shuffling gait. Pseudoparkinsonism is a side effect of antipsychotic medications like haloperidol, characterized by symptoms similar to Parkinson's disease. A shuffling gait, which is a slow, dragging walk with short steps and reduced arm swing, is a classic manifestation. Serpentine limb movement (A) is not associated with pseudoparkinsonism. Nonreactive pupils (C) are not a typical symptom of pseudoparkinsonism. Smacking lips (D) is a sign of tardive dyskinesia, another side effect of antipsychotic medications.
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
- A. Oxygen saturation 96%
- B. PaCO2 30 mm Hg
- C. Increase in BP
- D. Decrease in protein
Correct Answer: C
Rationale: The correct answer is C: Increase in BP. Albumin is a colloid solution that helps increase blood volume and subsequently improves blood pressure in shock patients. Increasing blood volume leads to an increase in blood pressure. Option A is incorrect because oxygen saturation is not directly affected by albumin infusion. Option B is incorrect because a low PaCO2 level is not a direct effect of albumin infusion. Option D is incorrect because albumin is a protein and its infusion would not lead to a decrease in protein levels.